Organization
CENTRAL LEATHERSTOCKING MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH C BOOTH MD (PHYSICIAN)
(315) 822-3200
Entity
Organization
Contact information
Practice address
943 US HIGHWAY 20, WEST WINFIELD, NY 13491-1920
(315) 822-3200
(315) 822-5193
Mailing address
943 US HIGHWAY 20, WEST WINFIELD, NY 13491
(315) 822-3200
(315) 822-5193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
175678
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02702638
—
NY
Enumeration date
07/24/2006
Last updated
08/22/2020
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